CLEVELAND CLINIC MARTIN HEALTH ALLERGY/DERMATOLOGY ON STAFF

Welcome to Vero Allergy & Dermatology!

Welcome to the website for Michael Wein, M.D.  Whether you’re learning about us for the first time, or you’re a long-time patient since we opened our doors over twenty years ago, we cover the fundamental aspects of allergy and dermatology to help get you up and running with your life, healthy and safe. We designed this website so you can learn about the basics of our practice. From setting up your first visit and establishing a treatment plan that's right for you, to the more advanced topics such as immunoglobulin replacement therapy, biologics, anti-leukotrienes, and allergy injection therapy, we’ve got you covered from start to finish. If you’ve been treating allergies for awhile now, you can jump around and find the topics most suitable to your needs. Thank you for taking this journey with us. We’d love your feedback. Join us on Facebook and let us know what topics you would like to know more about. Happy learning! — Dr. Michael Wein and the entire Vero Beach Allergy & Dermatology team.

What are some common allergens in Vero Beach?

Allergists know that people can be allergic to one or several allergens. The most common include pollens, molds, dust mites, animal dander, foods, medications, penicillin, and stinging insects such as wasps.

Is there only one type of allergic reaction?

• Seasonal allergic rhinitis, sometimes called hay fever, is often caused by an allergy to the pollen of trees, grasses, weeds, or mold spores. Depending on what you are allergic to, the section of the country, and the pollination periods, seasonal allergic rhinitis may occur in the spring, summer, or fall and may last until the first frost. Suffering may result in spells of sneezing, itching, and watery eyes, runny nose, cough, headache, and sore throat. Seasonal allergies also can trigger asthma.
• Eczema or atopic dermatitis is a itchy rash that often occurs on the hands, arms, legs, and neck, although it can cover the entire body. This condition is frequently associated with allergies, and many substances and sensitivities may aggravate it.
• Contact dermatitis is a reaction affecting areas of the skin that become red, itchy, and inflamed after exposure to allergens or irritants such as plants, cosmetics, medications, metals, and chemicals. Sometimes the allergen is airborne.
• Urticaria or hives are red, itchy, swollen areas of the skin that can vary in size and appear anywhere on the body. Approximately 25% of the U.S. population will experience an episode of hives at least once in their lives. Most common are acute cases of hives such as a reaction to a viral infection, medication, food, or latex. Some people have chronic hives that occur frequently for months to years with no clear trigger. Angioedema is a swelling of the deeper layers of the skin. It is not red or itchy, and most often occurs in soft tissue, such as the eyelids or mouth. Hives and angioedema may appear together or separately.

Dr. Michael Wein, M.D. has served as Chief of Allergy & Immunology at Indian River Medical Center for over 20 years. He is BOARD CERTIFIED by the American Board of Allergy and Immunology and completed advanced training in Allergy, Asthma & Immunology at Johns Hopkins. Our staff can perform skin testing to pollen, mold, pets, penicillin and food. We also treat dermatologist / allergic skin conditions such as eczema and chronic hives. We also offer Pulmonary Function testing for the evaluation and treatment of asthma, and can also provide Xolair, Fasenra, Nucala and Benralizumab therapy for asthma as well as Omalizumab for chronic hives (urticaria). We also evaluate and treat recurrent infections and our office can provide SCIG and IVIG gamma globulin replacement therapy. An allergist and immunologist might be able to help.

Allergist and immunologist
We perform same-day, extremely accurate allergy skin testing in our Port Saint Lucie and Vero Beach offices under close observation. You can leave our office knowing your exact allergies. 

Treatment of Allergies
We often recommend avoidance measures, prescribe medication such as antihistamines, anti-leukotrienes,  anti-cholinergics, decongestants, inhaled nasal steroids, asthma rescue inhalers, long-acting bronchodilators and many other anti-inflammatory medicines, but when enough relief isn’t obtained, allergy immunotherapy (allergy shots) is a powerful vaccine which can reduce and in some cases completely eliminate allergy symptoms. This is known as allergy desensitization and can last for many years. Allergy shots is the only treatment that targets the underlying causes of allergies and alters the natural course of the disease.

In Port Saint Lucie and Vero Beach, the allergy season unfolds in a predictable fashion. Tree pollen season usually starts in January, especially Oak and Australian Pine but also Bayberry and a few others. Then the grass pollen season typically starts a few months later, with Bermuda, Bahia and other species found in the Vero Beach and Port Saint Lucie area. The pollen season in Indian River County, for example, often lasts most of the year. With precipitation and unseasonably warm weather, factors have combined to increase the peak and extend the season.

For management of allergy symptoms, the best recommendation is often avoidance measures combined with regular medication. It’s often important for allergy patients to be taking medication on a regular basis every day - whether they think they need it or not. Usually, allergists recommend that people anticipate the pollen season and begin taking medication early in the season - or better yet before the season starts.

It’s also important for allergy sufferers to keep the windows in a car and home closed with the air conditioning on. This can help cut down the indoor pollen counts by 90% or more. And sleeping with the windows closed is also key because a peak for pollen release is between 5 a.m. and 10 a.m. as sunlight is a stimulus for some plants to release pollen.

Mold spores, more problems

Besides pollen, patients may also become sensitized to airborne mold spores. Molds can often be more of a problem than pollen, especially molds that are present in high amounts in damp, rainy conditions. Molds common in Port Saint Lucie and Vero Beach include Aspergillus, Alternaria, and Cladosporium, but also many others.   More importantly, though, warm weather can be a particularly bad time for mold. There are molds that peak on days of maximum heat and humidity. So later in the summer, particularly from mid-July to early-September, is when the mold count gets very high.

This can make a bad combination for many people who are allergic to both one or more pollen and molds. This is a common pattern, and you might have these symptoms year-round and have a peak of symptoms in the spring and summer. Many patients are polys-ensitized, or allergic to multiple allergens. Sometimes people have classic symptoms of rhino-conjunctivitis (nasal and eye symptoms) that occur seasonally –and we know it’s likely from ragweed. Quite frequently, people have year-round symptoms and there are peaks in the certain times of the year. On skin testing they’re sensitized to pollen and molds, as well as dust mites and cat or dog dander.

Geographic differences relevant to Port Saint Lucie and Vero Beach 'snowbirds' 

Complicating matters a bit further is that many locals are seasonal residents, and exposed to pollen in other areas geographically. For instance, in California, Bermuda grass is the major pollen allergen that triggers symptoms and ragweed isn’t an issue.  In Texas, it’s mountain cedar trees which pollinate early in the year, in January and February .

How to cope

While allergies can make you feel absolutely miserable, it doesn’t have to always be that way. A combination of avoidance and medication might help. For instance, closing the windows of your house (and your car when driving around) and using your air conditioner can greatly reduce the amount of pollen indoors.  Medication is also hugely important in helping to manage symptoms and keep you focused even when those pollen counts get high.  Intranasal steroids are the most effective medication for dealing with allergies. Available over-the-counter, Rhinocort, Nasacort and Flonase are intranasal steroids and are often effective. Another effective measure against allergies is oral antihistamines. If you’re going to take an antihistamine, you might choose one that’s either non-sedating or low-sedating. These, called second-generation antihistamines, include Claritin, Clarinex, Allegra, Zyrtec and Xyzal.

Allergists and Allergy shots

If these don’t work, there’s still hope. If you’re experiencing a level of symptoms that interferes with your desire to pursue activities or your symptoms are interfering with work or school performance, causing sleep disruption or sleep impairment despite avoidance measures and regular medications, you should see an allergist. Allergy shots, called allergen immunotherapy, are also an option for properly selected patients. The allergy shots offer the potential to affect the underlying allergic potential that drives symptoms.

With so many in Port Saint Lucie and Vero Beach suffering from seasonal allergies, it’s important to seek out the right combination of remedies, including seeing an allergist. We frequently see patients who are suffering needlessly …and an allergist can help.

Allergy to Florida Pollen - Trees, Grass and Weeds

Allergy is a reaction to a substance, such as pollen, mold, food, pet dander, or even a medication. Antibodies identify the protein in the allergen as an invading enemy and trigger an immune response.

Allergy reaction can be mild, or severe enough to need treatment or even emergency care.  A seasonal allergy, commonly referred to as hay fever, is also known as 'seasonal allergic rhinitis' 

In Florida, trees, grass and weeds flower in all seasons and continue producing pollen. 

Common Florida Allergens

Tree pollen season, especially Oak and Australian pine, runs from December through May. 

Grass pollen season, including Bahia and Bermuda grass, extends from April to October. 

Weed season for ragweed, goldenrod, sorrel and dog fennel is from May through December. 

Wind-blown allergens can travel for hundreds of miles. Just one plant produces more than one billion grains of pollen per season.

Ragweed is the best known, is found all over Florida, and is a major cause of allergies.  

Mold thrives in damp, humid, and cool environments, especially in decaying plant matter – leaves and grass clippings, compost piles and rotting, wet wood. Common species include outdoor molds such as Alternaria and Cladosporium but also indoor molds including Aspergillus and Penicillium.

Common Allergy Symptoms

• Itchy, stinging, and watery eyes 
• Scratchy throat and excess mucous
• Runny nose, nasal congestion, watery nose
• Asthma 
• Fatigue
• Congestion
• Trouble Sleeping
• Coughing and wheezing
• Swollen Eyelids
• Wheezing

Is it allergy, or the flu, or just a cold: 

Allergy and the flu or a cold trigger similar symptoms – they can often be confused! Symptoms that last over two weeks may indicate allergies, but a fever suggests it is a viral infection and not an allergy.

Medical Steps in Planning for Allergies

One key is to start treatment proactively before symptoms appear.

1. Get tested to determine the specific pollens you are allergic to, as it takes about 15 minutes, does not require needles, and the results are available at the office the same day. Then, be sure to consider the allergist’s advice and perhaps prescriptions. Allergy injections can dramatically improve symptoms.

2. Allergy immunotherapy treatments introduce small doses of an allergen to gradually acclimatize your body and induce long-term tolerance. The results might surprise you.

3. Nasal saline sprays, anti-leukotrienes, and steroids may help reduce symptoms.

4. Over-the-counter and prescription antihistamines can also help.

Prevention

Track pollen counts in Port Saint Lucie at the National Allergy Bureau website (aaaai.org/nab) to minimize exposure. A local weather report may also include the pollen count.

Wear a dust mask to filter out pollen, especially when working outside.

Flush your eyes and wash hands often and keep them away from your face. Shower and wash hair after outdoor activities to remove any clinging pollen.

Change and wash all outdoor clothing promptly when returning to the home.

Avoid air-drying laundry outside.

Good Housekeeping for Combating Allergens

• Use air conditioning in the car and home to filter the air. 
• Clean your HVAC system regularly.
• Purchase a HEPA filter unit to reduce allergens.
• Remove indoor plants.
• Keep bathrooms and kitchen dry, well-ventilated, perhaps purchase dehumidifier.
• Consider replacing carpeted floors with wood or tile.
• Prevent build-up and spread of mold by cleaning with bleach.

Treasure Coast residents enjoy many advantages, but pollen is one hurdle for some. At Vero Allergy & Dermatology, we offer testing, diagnosing, and treatment for allergy and asthma. If you’ve tried everything to treat your allergies, and nothing helps, call us for an appointment!